Department Name:

Exhibitors Name:

Address:

City:

State:

Zip:

E-Mail Address:

Telephone No.

Junior Exhibitor’s Birthday

Please Check: Open Exhibitor Q

Junior Exhibitor Q

Division No.

Class No.

Breed

Sex

Date of Birth

Registration #

Out of County Livestock Exhibitor Fees: $10.00 per animal

Fee Due with Entry Form by July 25, 2008

Release and Waiver by Junior Exhibitor and Parent or Guardian

I, the undersigned, hereby release the management and board members of the Fulton County Fair Association and their officers, members, agents, employees, or volunteers of and from all claims, demands, action or cause of action, of any nature whatsoever, whether known now or ascertained, or which may hereafter develop or accrue through me in favor of myself, my hires, representative, appointees, or dependents, on account of , or by reason of any injury, loss or damage, which may be suffered by me or then or any of them, or any property, aminate or inaminate, belonging to me or used by me because of any manner, thing or conditions, negligence or default, whatsoever and I hereby assume and accept the full risk and danger of any hurt, injury or damage which may occur through or by any reason of any manner, thing or condition, negligence or default, or any person or persons whatever.

We will publish winners on our website and may include photographs of individuals and groups.  Names of individuals may be used to identify these people in photographs.  Individuals with Internet access around the world will be able to view this information.  We will publish photographs and names only with your written permission. My signature indicates that I grant permission for the name and/or photograph of the above exhibitor to be published on the World Wide Web. 

Do not publish my photo on the World Wide Web o

Signature of Junior Exhibitor:                                                                                         Date:

Signature of Parent or Guardian                                                                                      Date:

Mail to: Fulton County Fair Livestock Department, Post Office Box 910, Salem, AR 72576

Entries may also be left at the Fulton County Extension Office